| NPI | 1548237225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000261) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE NE100472) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-07-21 |